... to a state which is actively attacking and removing the fundamental human rights of homebirth families.
Let's look at some of what's going on in the sunshine state:
Removal of Informed Consent
Informed consent is the hallmark and bedrock of midwifery care. In true informed consent, a client is presented with all information (including pros and cons) of every available test and/or procedure. The client makes a decision, and the midwife then respects that decision.
Under new interpretation of statutes, informed consent has been almost completely removed. An overwhelmingly large number of prenatal, intrapartum, and postpartum tests and procedures are now absolutely mandatory, and the client has no say in decision-making for herself or her baby. (See the full list here.)
And what happens if the clients should be so bold as to assert their basic human right to refuse the administration of an unwanted test or procedure?
Mandatory Client Abandonment
That's right. Should a client refuse a "mandatory procedure" during the prenatal, labor, or postpartum periods, the midwife is commanded to terminate care instantly. That means dismissing a pregnant client who refuses an unwanted test. It means packing up and walking out the door if a client refuses the now mandatory vaginal exam(s) during labor. For any of a large number of possible infractions, a midwife is to abandon the client instantly if the client refuses compliance.
Let's go back briefly to the "now mandatory" vaginal exam(s) during labor.
Guess what? A client no longer has the right to say NO.
There are words to describe what it means when someone says, "Let me stick this in your vagina, or I will do bad things to you."
Coercion. Assault. Rape.
Coercive "choice" is not choice, because true informed consent implies the possibility of unpunished informed refusal. When the "choice" is "do what I want you to do, or I will do something bad to you," that is coercion - not informed consent. When a midwife is forced to say, "Let me do a vaginal exam, or I will walk out this door and let you birth on your own," she is being forced to practice coercive and abusive care.
Hospital birthers are no strangers to coercive care. It is common, if not the norm, for obstetricians to practice this type of care. I've experienced it myself. But homebirth clients seek out homebirth midwives because they specifically wish to have their wishes, decisions, and the right to personal and medical autonomy respected and upheld. Homebirth midwives practicing under the golden standard of informed consent are now being forced to practice coercive care, and the basic bodily and medical rights of homebirth clients are subsequently violated.
More Mandatory Client Abandonment
Additional requirement that midwives abandon care come under the following circumstances:
(1) A client may not see her midwife after the baby is 5 weeks and 5 days old. Once the baby turns six weeks, a client may not see her midwife for any reason (without risk of the midwife losing her license). This means that a client may not see her midwife for continuing issues - like recovery from birth injuries, or breastfeeding problems - or for well-woman care.
(2) A client may not see her midwife once a pregnancy or labor has been transferred, however briefly, to a physician or hospital. This means that if a client has any reason to transfer care to a doctor's care or to a hospital (for example, for fluids, suturing, postpartum complications, etc.), she may no longer see her midwife for any reason - even after the attending physician or hospital has cleared her to return to the care of her midwife. She is now abandoned to find new care and cannot see her midwife for any reason - even if her pregnancy/labor/postpartum is now completely normal, or if she needs simple care like a postpartum check-up or help with breastfeeding.
See the full run-down here.
Where Is This Headed?
It is believed that this is only the beginning in attacks against Arizona homebirth families. In other words, if you're not scared, you should be. Important human rights can be only one tiny personnel or policy change away from being obliterated, and we are seeing this happen here. This leads me to the most important point:
How Can I Help?
Let me make this clear: This is an issue that must be tackled by consumers. You. Me. This means - GET INVOLVED NOW if you want homebirth rights to be protected (and restored) in the state of Arizona. To change the minds and hearts of those in charge is going to take serious hard work.
Here's how you can help.
(1) Subscribe to this blog.
(2) Join the Rights for Homebirth Facebook group for activism updates.
(3) Make sure you are actively participating in any online forums provided by your care provider so that you can get important information.
(4) Contact your midwife and let her know that you love and support her. Ask what she needs and how you can help.
(5) Write letters. A basic list of persons concerned is added below. Please keep letters polite, formal in style, non-attacking, focused on the rights of homebirth families, and using keywords like medical and bodily autonomy and parental rights.
A Brief Aside
It is the absolute conviction of this blogger that:
(1) Homebirth is a healthy and viable choice for families.
(2) The right to informed consent and refusal and the right to personal and medical autonomy are absolute in all circumstances.
Should you disagree with the above (and I hope you don't!), please know that I am not interested in starting debates here. Any "I love to see the rights of homebirth families being attacked!" comments will be quietly deleted without comment.
Additionally, please know that I do not have all the answers. If you have questions, please head over to the above-mentioned blog and/or Facebook group to ask questions of people who are truly in the know.
And with that said...
Get involved now!
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Letters may be sent to the following individuals. Email addresses are included below, but physical letters are almost always more effective. If you can take a few minutes, print them out and mail them!
(I directed my letter to Director Humble and did a CC to all the others, so I only had to write one letter and sent a copy of it to each of the below.)
Director Will Humble
Office of the Director
150 N. 18th Avenue, 5th floor
Phoenix, AZ 85007
will.humble@azdhs.gov
The Honorable Janice K. Brewer
Arizona Governor
Executive Tower
1700 West Washington Street
Phoenix, AZ 85007
(email form is on her website: http://azgovernor.gov/contact.asp)
Cara Christ, Chief Medical Officer
Division of Licensing Services
150 N. 18th Avenue, 5th floor
Phoenix, AZ 85007
cara.christ@azdhs.gov
Pragathi Tummala
Arizona Department of Health Services
1740 W. Adams Street
Phoenix, AZ 85007
Pragathi.Tummala@azdhs.gov
Donald Gibson
Arizona Division of Licensing Services
Office of Special Licensing
Phoenix, AZ 85007
Donald.Gibson@azdhs.gov
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